Due to financial circumstances, people often have a lost tooth restored with a removable partial denture, an effective appliance that restores function and a degree of aesthetic appearance. Later, though, they may want to improve both function and appearance with a dental implant.
If this describes you, you’re making a great choice. Dental implants are the closest technology we have to a natural tooth. But there may be a roadblock to your implant, especially if a long time has passed since your tooth loss—there may not be enough bone at the site to place an implant.
The heart of an implant is a titanium metal post surgically imbedded in the jawbone. The titanium naturally attracts bone cells, which grow and adhere to it to form a solid hold that can support a porcelain crown or other restorations like bridges or dentures. But to achieve a natural appearance it’s important that the implant is placed in the right location. To achieve that requires adequate bone.
But there may not be adequate bone if the tooth has been missing for a while. The forces generated when we chew travel through the teeth to the jawbone, which stimulates bone growth. If that stimulus is absent because of a missing tooth, new bone cells may not replace older ones at a healthy rate and the total bone volume begins to diminish. A denture can’t compensate and, in fact, accelerates bone loss.
But there may be a solution: bone grafting. With this procedure we place a donor bone graft into the area of bone deficiency some time before implant surgery. The graft serves as a scaffold for new bone cells to grow upon. Hopefully, this will produce enough healthy bone to support an implant. If the bone deficiency is minor, we may place the implant and the bone graft at the same time.
If you have experienced bone loss, we must first determine the amount of bone at the missing tooth site and whether grafting is a viable option. Bone grafting postpones your implant, but the delay will be worth the wait if we’re successful. With increased bone volume you’ll be able to obtain a new tooth that’s superior to your current restoration.
Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.
In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.
For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.
Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.
It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.
That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”
We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?”
Accidents happen, especially to teenagers involved with sports or similar activities. In an instant they can lose one or more teeth and permanently alter their smile.
Fortunately we can restore a teenager’s lost teeth, but often not immediately as a permanent restoration with a dental implant requires maturity of their jaw structure. Our focus then turns to the age of the patient and the condition of the underlying bone. A future dental implant, your best choice for tooth replacement, depends on bone for support, but also the age of the patient as it relates to jaw development.
There are a couple of ways an accidental tooth loss can harm supporting bone: first and foremost, the impact of the accident itself can damage the bony socket. To find out for sure we may need to perform a cone beam scan, a type of x-ray that allows us to view the area three-dimensionally. If we do find damage, we can attempt to repair the socket through bone grafting.
Bone can also suffer from the long-term absence of a tooth. Bone has a growth cycle in which older cells dissolve and new ones form to take their place. The force generated by teeth when we eat or chew helps stimulate this growth. Without stimulation, as with a missing tooth, the bone may not grow at a healthy rate. In time, it could lose some of its volume and density and not be able to support an implant.
Installing an implant right after tooth loss could help avoid this situation. Bone has a natural affinity with the titanium post imbedded in the jaw and will naturally grow and adhere to it. But we can’t place an implant with a teenager. This is because the jaw is still developing so an implant would gradually become misaligned as the jaw grows. It’s best to install an implant later after full jaw development in early adulthood.
Today, we can place a bone graft in the empty socket right after tooth loss. The graft serves as a scaffold for bone cells to grow on and will help keep the bone volume at a healthy level until we can install an implant.
Timing is everything in restoring a teenager’s accidental tooth loss. But with coordination and care for the supporting bone, a teenager can eventually enter their adult years with their smile intact.
If you would like more information on restoring your teenager’s smile after tooth loss, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”